title: Spinal cord injury-related chronic pain in victims of the 2008 Sichuan earthquake: a prospective cohort study.
abstract: METHODS
  Prospective cohort.
  
  
  OBJECTIVE
  To characterize spinal cord injury (SCI)-related pain and treatment in victims of the 2008 Sichuan earthquake.
  
  
  METHODS
  Mianzhu County, China.
  
  
  METHODS
  Twenty-six patients who sustained SCI in the 2008 Sichuan earthquake and who were treated in the same hospital were enrolled. Data was collected on pain severity with a visual analog scale, depression with Patient Health Questionnaire-9, quality of life (QoL) with World Health Organization Quality of Life-BREF and social participation with the Craig Hospital Handicap Assessment and Reporting Technique Short Form at three assessment points. Detailed pain descriptions including therapeutic interventions were elicited at the fourth assessment. Pain determinants were analyzed with a longitudinal Tobit regression, and Pearson's correlations of pain severity with depression, QoL and social participation stratified by measurement point were calculated.
  
  
  RESULTS
  SCI-related pain was highly prevalent and prevalence of neuropathic pain was nearly twice that of nociceptive pain. Most patients reported pain since the onset and severity was not significantly reduced over time. Cervical injury, complete lesions and education level were significant pain determinants. Depression and QoL scores were highly correlated with pain at the first two assessments points but not at the third measurement. Most patients did not seek treatment because they regarded pain as either a normal condition after SCI or were afraid of drug dependency.
  
  
  CONCLUSIONS
  This initial longitudinal assessment and characterization of SCI-related pain in earthquake victims provides a foundation for further exploration of the biological and psychosocial determinants of pain severity and of the correlation of chronic pain with other outcomes of interest in this population. Patient pain-treatment-seeking behavior and therapeutic interventions should be evaluated concurrently.
authors.affiliation: 1] Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China [2] Caring For Children Foundation, Hong Kong, China.
authors.forename: H
authors.initials: H
authors.lastname: Wen
authors.forename: J D
authors.initials: JD
authors.lastname: Reinhardt
authors.forename: J E
authors.initials: JE
authors.lastname: Gosney
authors.forename: M
authors.initials: M
authors.lastname: Baumberger
authors.forename: X
authors.initials: X
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D059350:Chronic Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D015331:Cohort Studies; D003863:Depression; D004185:Disability Evaluation; D055866:Earthquakes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology* / Q000523:psychology